Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
Magnetic resonance imaging techniques used for the initial evaluation, pre-procedural assessment, and follow-up of patients with CoA10,11
| Spin-echo CMR | Initial assessment of the location and degree of stenosis |
| Contrast-enhanced 3D CMR | Better visualization of the aorta in patients with repaired CoA10 |
| Phase-contrast, velocity-encoded cine CMR | Hemodynamic measurements - flow deceleration in descending aorta, pressure gradients Assessment of the smallest aortic cross-sectional area11 |
| 4D flow CMR | Measurement of peak systolic pressure across CoA, wall-shear stress, and oscillatory shear index using computational fluid dynamics11 |
Recommendations for intervention in CoA or re-coarctation_
| Class. Level | Recommendations |
|---|---|
| I C | Repair of CoA or re-coarctation (either surgical or interventional) is indicated in hypertensive patients with an increased non-invasive gradient between upper and lower limbs confirmed invasively (peak-to-peak ≥20 mmHg). |
| IIa C | Stenting should be considered in hypertensive patients with >50% narrowing relative to the aortic diameter at the level of the diaphragm even if invasive peak-to-peak gradient is <20 mmHg. |
| IIa C | Stenting should be considered in normotensive patients with an increased non-invasive gradient confirmed invasively (peak-to-peak gradient of ≥20 mmHg). |
| IIb C | Stenting may be considered in normotensive patients with >50% narrowing relative to the aortic diameter at the level of the diaphragm even if invasive peak-to-peak gradient is <20 mmHg. |